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Optimizing Mental Health Referrals in a University Based Primary Care Clinic
Journal of the Academy of Consultation-Liaison Psychiatry ; 63:S57-S58, 2022.
Article in English | EMBASE | ID: covidwho-1966670
ABSTRACT
Background/

Significance:

Primary care settings are often the first point of contact for psychiatric diagnosis, treatment, and referral – and primary care clinicians manage many psychiatric illnesses in the community. Integrated and collaborative care models have grown in response to the recognized need for psychiatric services in the primary care setting. Despite increased psychiatric presence, access to mental health services remains a challenge for patients and primary care providers. This challenge is particularly notable in racially diverse and socioeconomically disadvantaged patient populations and is further exacerbated by the COVID-19 pandemic, which disproportionately affects these groups. We describe an initiative to improve equity and access to mental health services among racially diverse and socioeconomically disadvantaged patients in a primary care clinic affiliated with an academic teaching hospital.

Methods:

We convened a meeting of internal medicine, psychiatry, social work, and administrative stakeholders affiliated with our university-based primary care clinic. This clinic primarily serves low income, racially diverse, and/or immigrant populations. We reviewed provider needs related to mental health referrals and compiled a comprehensive list of local outpatient, partial hospital, inpatient, addiction, and emergency resources. We then created an algorithm to direct providers to the appropriate resources based on the presenting mental health concern. This algorithm has been integrated into the electronic medical record (EMR) for easier access and use. Clinicians were surveyed pre-training and deployment of the algorithm and will be surveyed in follow up to measure its benefits.

Results:

The majority of primary care providers did not feel confident with psychiatric referral options. The most frequently described reason for psychiatric intervention was for depression and anxiety. Among mental health questions, a majority could be addressed with the assistance of a referral.

Discussion:

Despite increasing psychiatry presence in primary care, challenges remain in accessing mental health services. The COVID-19 pandemic has exacerbated existing challenges with increased demand for services. Our project builds on an existing integrated care model and introduces a resource that further streamlines mental health referrals. By having this resource available both physically in the clinic and embedded within the EMR, we hope to enhance the ease and efficiency of referral. Conclusion/Implications A streamlined referral process can further aid in improving access to mental health services within a clinic already using an integrated care model. This is particularly important given the increased need for mental health services in low income, diverse, and immigrant populations hit hard by the COVID-19 pandemic. References 1. Rothman S, Gunturu S, Korenis P. The mental health impact of the COVID-19 epidemic on immigrants and racial and ethnic minorities. QJM. 2020;113(11)779-782. 2. Jackson-Triche ME, Unützer J, Wells KB. Achieving Mental Health Equity Collaborative Care. Psychiatr Clin North Am. 2020;43(3)501-510. 3. Lee-Tauler SY, Eun J, Corbett D, Collins PY. A Systematic Review of Interventions to Improve Initiation of Mental Health Care Among Racial-Ethnic Minority Groups. Psychiatr Serv. 2018;69(6)628-647.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of the Academy of Consultation-Liaison Psychiatry Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of the Academy of Consultation-Liaison Psychiatry Year: 2022 Document Type: Article